It’s a no-brainer that bullying is wrong. But what about plastic surgery on a 13-year-old? Is that appropriate?

I’m putting the question out there, not just to plastic surgeons, but to any readers with an opinion. What do you think? And what about other types of plastic surgery on teens?

Here is a Q&A I did with Dr. Semira Bayati, a board-certified plastic surgeon in Newport Beach:

Generally, What age is too young to get a nose job?

“Facial development, specially in the nasal area, is not complete until age 15 for females and 17 for males. Surgical alterations prior to these ages could lead to deformity, need for repeat surgery later and are generally not recommended.”

Aren’t a 13-year-old’s facial features still growing?

“Absolutely. Aside from the ears that reach their adult age by 6, making ear reshaping possible at a young age, other facial development is not complete until age 15 for females and 17 for males. Aside from correcting congenital or traumatic deformity that is considered medically necessary for form and function, elective facial surgery should be postponed until facial development is complete. Further, due to personality and identity development during these critical teenage years, facial alterations could have detrimental effects if it is done prematurely.”

Have you been approached by any families wanting to get plastic surgery at what you felt was too young an age? If so, did you turn them away?

“Yes, I have mothers coming in with their teenage daughters asking for ‘package deals’ for breast augmentation or liposuction. Orange County, of course, is a unique market in terms of the volume of cosmetic surgery. There are cheerleaders in their teenage years who come in with a parent asking for liposuction of ‘problem areas’ such as a ‘muffin top’ or disproportionately large belly or saddlebags.

“As a rule, I will not perform breast augmentation until a patient is at least 18 years of age. I think there is a need for maturity and responsibility that comes with age and this surgery involves a device that requires maintenance and risks that only an adult is mature enough to consider.

“For spot liposuction of problem areas, when genetically someone has a disproportionate body, I reserve body contouring such as liposuction until after 15 for girls and 17 for boys. Living in a beach community and a very body-conscious society, problem areas that are resistant to diet and exercise could pose a daily psychological problem in this age group. We do not always have control over our shape or genetics. Minor alterations in a critical age, that won’t interfere with overall health and well being in the long-run, could be life-altering and motivating for a young person.“It is however, very important to choose the candidates wisely. These operations do not substitute a healthy eating and active lifestyle and are only advised when it is meant as a complement to these habits.

“As a rule, if a generally heavy adolescent presents with parents for consideration of liposuction, I will turn them away. I feel that diet and exercise is a lifestyle that should come first and liposuction should only be reserved for problem areas that remain despite healthy living.

“[Another problem area is] when a very young girl has such rapid and disproportionate growth of her breast tissue that it keeps her from activities and causes neck and back strain. Generally, breast reduction is advised in a young girl, usually after 15 years of age for this indication and is not considered a cosmetic operation.”

What is a youngest patient that you have performed cosmetic surgery on?

“I have done liposuction on 15-year-old girls who are thin, but have a huge buttock, or large saddlebags, etc. and nose jobs on 17-year-olds. Though ear reshaping for prominent ears is not medically necessary, I have performed many of these operations on children who are getting teased by other children. These children have psychological trauma from teasing and ridicule. Since ears reach their adult size by age six. In the plastic surgery community, ear reshaping is acceptable after that age and is recommended in order to avoid long-term psychological issues.”

Marilyn Kalfus covers news, issues, and trends for The Orange County Register's award-winning Sunday Real Estate section, which in 2015 and 2017 snagged the top prize for best U.S. newspaper real estate section from the National Association of Real Estate Editors. She also writes stories, edits photos and puts together slideshows for our popular Hot Homes feature about iconic, big-ticket and unusual properties on the market. On weekends, she edits police, breaking news and general assignment reporters.